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Hanna R, Dalvi S, Tomov G, Hopper C, Rebaudi F, Rebaudi AL, Bensadoun RJ. Emerging potential of phototherapy in management of symptomatic oral lichen planus: A systematic review of randomised controlled clinical trials. JOURNAL OF BIOPHOTONICS 2023:e202300046. [PMID: 37017292 DOI: 10.1002/jbio.202300046] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/01/2023] [Accepted: 04/02/2023] [Indexed: 06/19/2023]
Abstract
Phototherapy incorporating photobiomodulation therapy and antimicrobial photodynamic therapy has been utilised as antioxidants in symptomatic oral lichen planus (OLP) management; however, its role of intervention remains controversial. The aim of this systematic review of CRD42021227788 PROSPERO (an international prospective register of systematic reviews in health and social care) registration number was to oversee and determine phototherapy efficacy in patients with symptomatic OLP, identifying and bridging the literature gaps by proposing recommendations for future studies. A search strategy was developed in consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various electronic databases were exercised to search for randomised controlled clinical trials (RCTs). Several search engines were employed to analyse a total of 177 studies of which nine included. A wide range of utilised laser and light-emitted diode wavelengths between 630 and 808 nm and irradiance ranged between 10 and 13 mW/cm2 were noted. 67% of studies reported a high risk of bias and a high heterogeneity obtained from numerical data for quantitative analysis, therefore meta-analysis was impossible to conduct. Despite inconsistency and diversity in phototherapy parameters, treatment protocols, photosensitiser (type, concentration and method of application) and outcome assessment tools, the majority of the studies showed positive results compared with standard care treatments. Hence, a necessity to perform well-designed RCTs with robust methodology is warranted, after acknowledging the current drawbacks and addressing the suggested recommendations highlighted in our review. Moreover, advanced knowledge in understanding further phototherapy-antioxidants molecular mechanistic in symptomatic OLP is required.
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Affiliation(s)
- Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
- Department of Restorative and Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London, UK
| | - Snehal Dalvi
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, India
| | - Georgi Tomov
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Colin Hopper
- Department of Maxillofacial Surgery, Diagnostics, Medical and Surgical Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London, UK
| | - Federico Rebaudi
- Department of Expiremental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Alberto Luigi Rebaudi
- Department of Surgery and Implants, School of Dentistry, Universitat International de Catalunya (UIC), Barcelona, Spain
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Polizzi A, Santonocito S, Lo Giudice A, Alibrandi A, De Pasquale R, Isola G. Analysis of the response to two pharmacological protocols in patients with oral lichen planus: A randomized clinical trial. Oral Dis 2023; 29:755-763. [PMID: 34252252 DOI: 10.1111/odi.13960] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/10/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two different therapies on oral lichen planus (OLP) treatment through the analysis of OLP symptoms and signs and to analyze the risk of side effects related to the adopted protocols. METHODS Thirty-eight patients with OLP were selected according to van der Meij and van der Waal clinical and histopathological criteria. Through a randomized design, 19 patients received Tacrolimus 0.1% ointment (T group) and 19 an anti-inflammatory mouthwash (M group) composed of calcium hydroxide 10%, hyaluronic acid 0.3%, umbelliferone, and oligomeric proanthocyanidins. The patients were examined on a regular basis for OLP symptoms, signs, and disease severity score changes over a 3-month follow-up period. RESULTS Both treatments were effective in the reduction of OLP signs and symptoms. However, at 3 months (T3), in comparison with the M group, T group patients showed significantly lower mean values of OLP signs (p = 0.035), symptoms (p = 0.045), and disease severity scores (p = 0.041). Moreover, the Spearman test showed that there was a significant correlation between OLP signs and symptoms at each follow-up session in all patients. CONCLUSIONS Both treatments demonstrated a significant approach to control OLP. However, tacrolimus determined a more effective improvement in OLP signs and symptoms compared to anti-inflammatory mouthwash at 3-month follow-up.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, Messina, Italy
| | - Rocco De Pasquale
- Department of General Surgery and Surgical-Medical Specialties, Unit of Dermatology, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
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Nicolas‐Boluda A, Simon S. Validation of the French version of the ICHOM adult oral health standard set. Clin Exp Dent Res 2023; 9:142-149. [PMID: 36419362 PMCID: PMC9932232 DOI: 10.1002/cre2.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/13/2022] [Accepted: 09/23/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The ICHOM Adult Oral Health Standard Set (AOHSS) recently developed by the ICHOM Oral Adult Health Working Group is a standard set of outcomes designed for its collection in clinical practice in dental health. The outcome standard set is made up of clinical-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs). The purpose of this study was to translate and cross-culturally adapt the PROM section of the Standard Set in French for France to enable comprehensive evaluation of the patients' oral health quality of life in a French population. METHODS The questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcome Research (ISPOR). We included patients consulting in a dentistry clinic (n = 127) and seeking dental care. The PROM and CROM data were collected from all patients. Both reliability and the internal consistency were evaluated. RESULTS The ICHOM AOHSS was successfully translated into French. We sampled and surveyed 126 patients in a dentistry clinic in France using the French translation of the ICHOM AOHSS. Cronbach's α was calculated to measure the internal consistency. The resulting Cronbach's α was 0.8, indicating acceptable homogeneity. CONCLUSIONS The French version of the ICHOM AOHSS shows acceptable psychometric properties in terms of reliability and internal consistency. This translation is suitable for its implementation in a French-speaking patient population.
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Affiliation(s)
| | - Stephane Simon
- Université de Paris, UFR d'OdontologieParisFrance
- Endo AcademieRouenFrance
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Ali S, Nagieb CS, Fayed HL. Effect of Behcet's disease-associated oral ulcers on oral health related quality of life. SPECIAL CARE IN DENTISTRY 2022. [PMID: 36127751 DOI: 10.1111/scd.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/06/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
AIM The current study assessed the clinical characteristics of patients suffering from Behcet's disease (BD)-associated oral ulcers and investigated the effect of these oral ulcers on the oral health-related quality of life (OHRQoL). METHODS This study included BD patients suffering from active oral ulcers, defined by the revised International Criteria for BD (ICBD) criteria. We collected BD and oral ulcers characteristics. The oral ulcer activity index and OHRQoL were measured by composite index (CI) and Oral Health Impact Profile-14 (OHIP-14), respectively. RESULTS Genital and ocular manifestations were the most frequent. Ocular manifestations were the main diagnostic manifestation. The mean age of BD diagnosis and first oral ulcer appearance were 32.15 ± 8.96 and 29.62 ± 9.04, respectively. Minor oral ulcers were more frequent; solitary or multiple. CI revealed that pain was more severe than functional disability. OHIP-14 showed that patients suffered more often from pain and difficulties in eating. Patients reported feeling tense, being irritable, doing usual job with difficulty, and having less satisfying life. CONCLUSION BD-associated oral ulcers lead to poor quality of life. Female gender, multiple ulcers, and buccal mucosa were associated with more severe pain and functional disability as well as poorer quality of life.
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Affiliation(s)
- Shereen Ali
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Egypt
| | - Clair Sobhy Nagieb
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Egypt
| | - Hala Lotfy Fayed
- Department of Rheumatology & Rehabilitation, Faculty of Medicine, Cairo University, Egypt
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Kakoei S, Karbasi N, Raeiszadeh M, Tajadini H, Nekouei AH. The efficacy of henna (Lawsonia inermis L.) mouthwash versus chlorhexidine gluconate 0.2% mouthwash as adjuvant therapy of oral lichen planus: A randomized double-blind clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2022; 290:115037. [PMID: 35134489 DOI: 10.1016/j.jep.2022.115037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/12/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In modern medicine, some traditional remedies are introduced to be effective in treatment. Accordingly, the henna plant (Lawsonia inermis L.) is studied more than before. Previous studies have shown many medical properties for henna, such as anti-inflammatory and anti-fungal properties. AIM OF THE STUDY Oral lichen planus (OLP) is a common mucocutaneous disease with chronic immunomodulatory disruptions. Topical corticosteroids are the first line of OLP treatment. Previous studies have suggested different adjunctive therapies for preventing the side effects of corticosteroids overuse. This study aimed to compare the effects of henna and chlorhexidine mouthwashes as adjunctive therapy. MATERIALS AND METHODS This parallel-group, double-blind, randomized controlled study was conducted on forty OLP patients. Luteolin content was determined in Henna mouthwash composed of 2% aqueous extract of henna, 2% ethanol, 10% glycerol, and 0.1% methylparaben distilled water. Henna or chlorhexidine mouthwashes were prescribed twice daily as an adjuvant to the topical corticosteroid treatment. Visual analog scale (VAS) index and Thongprasom rating were used to measure pain intensity and clinical signs of patients at days 0,7, and 14. The collected data were analyzed using SPSS software (version 26.0; SPSS). Ordinal logistic regression was used to investigate the effect of independent variables on Thongprasom and VAS scores. RESULTS In this clinical trial, 82.6% of the participants were women. There was no difference between the two study groups in terms of VAS scores (p = 0.404) and clinical features (p = 0.305) in the second follow-up visit. All drug regimens caused clinical signs and symptoms relief. CONCLUSIONS There was no significant difference between the groups receiving topical corticosteroid supplementation, neither henna mouthwash nor chlorhexidine mouthwash. The therapeutic effects of henna mouthwash in the main or adjuvant treatment of OLP need more evaluation in future research. Henna mouthwash can be a good alternative to chlorhexidine mouthwash if no side effects are reported.
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Affiliation(s)
- Shahla Kakoei
- Department of Oral and Maxillofacial Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Nahid Karbasi
- Department of Oral and Maxillofacial Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahboobeh Raeiszadeh
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Haleh Tajadini
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Amir H Nekouei
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Guberti M, Botti S, Fusco A, Caffarri C, Cavuto S, Savoldi L, Serra N, Merli F, Piredda M, De Marinis MG. Stem cell transplantation patients receiving a novel oral care protocol for oral mucositis prevention and treatment: patient-reported outcomes and quality of life. Support Care Cancer 2022; 30:6317-6325. [PMID: 35474550 PMCID: PMC9135813 DOI: 10.1007/s00520-022-07073-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/18/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Oral mucositis (OM) is one of the most debilitating effects of toxicity due to hematopoietic stem cell transplantation (HSCT) conditioning regimens. The aim of this secondary analysis of the data of a phase II study designed to assess the efficacy of a novel oral care protocol containing bovine colostrum and aloe vera to prevent oral mucositis was to compare outcomes reported by patients with those collected by healthcare professionals (HCPs). METHOD Data on oral mucositis severity, duration, time of onset and related pain were collected from patients using the Oral Mucositis Daily Questionnaire (OMDQ). HCPs assessed the same outcomes using the World Health Organization oral mucositis scale and pain numerical rating scale. Quality of life was assessed with the 3-level EuroQol-5 dimensions. RESULTS Fifty-nine autologous/allogeneic graft patients were recruited, 46 of whom (78.0%) experienced OM. Mean onset was 9.1 (SD ± 3.5) days after conditioning initiation, mean duration was 10.4 (SD ± 4.3) days, and the average maximum pain score was 3.7 (SD ± 2.7). Self-administration of the OMDQ detected oral symptoms at least 1 day sooner compared to objective assessments (p = 0.025). Significant differences were observed between the patient-reported and the HCP-assessment data on oral mucositis severity grading distribution (p < 0.0001) and highest pain score (p < 0.0001). Quality of life score variations were correlated with changes in oral mucositis severity during patients' hospital stay. CONCLUSIONS Further studies are necessary to improve the understanding of these findings; a randomised controlled trial is being set up at our institution.
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Affiliation(s)
- Monica Guberti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Stefano Botti
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
- Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Andrea Fusco
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Cristiana Caffarri
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, SC Infrastructure, Research and Statistics, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42123 Reggio Emilia, Italy
| | - Luisa Savoldi
- Clinical Trials and Statistics Unit, SC Infrastructure, Research and Statistics, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42123 Reggio Emilia, Italy
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Michela Piredda
- Research Unit Nursing Science, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
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Costa-da-Silva AC, Aure MH, Dodge J, Martin D, Dhamala S, Cho M, Rose JJ, Bassim CW, Ambatipudi K, Hakim FT, Pavletic SZ, Mays JW. Salivary ZG16B expression loss follows exocrine gland dysfunction related to oral chronic graft-versus-host disease. iScience 2022; 25:103592. [PMID: 35005541 PMCID: PMC8718990 DOI: 10.1016/j.isci.2021.103592] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/01/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022] Open
Abstract
Chronic graft-versus-host disease (cGVHD) targets include the oral mucosa and salivary glands after allogeneic hematopoietic stem cell transplant (HSCT). Without incisional biopsy, no diagnostic test exists to confirm oral cGVHD. Consequently, therapy is often withheld until severe manifestations develop. This proteomic study examined saliva and human salivary gland for a biomarker profile at first onset of oral cGVHD prior to initiation of topical steroid therapy. Whole saliva collected at onset of biopsy-proven oral GVHD was assessed using liquid chromatography-coupled tandem mass spectrometry with identification of 569 proteins, of which 77 significantly changed in abundance. ZG16B, a secretory lectin protein, was reduced 2-fold in oral cGVHD saliva (p <0.05), and significantly decreased in salivary gland secretory cells affected by cGVHD. Single-cell RNA-seq analysis of healthy MSG localized ZG16B expression to two discrete acinar cell populations. Reduced ZG16B expression may indicate specific cGVHD activity and possibly general salivary gland dysfunction.
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Affiliation(s)
- Ana Caroline Costa-da-Silva
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | - Marit H. Aure
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | - Joshua Dodge
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | - Daniel Martin
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | - Susan Dhamala
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
- National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Monica Cho
- National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | | | - Carol W. Bassim
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | - Kiran Ambatipudi
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
| | | | | | - Jacqueline W. Mays
- National Institute of Dental and Craniofacial Research, NIH, Building 30, MSC 4340, 30 Convent Drive, Bethesda, MD 20892, USA
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Rashid H, Lamberts A, Borradori L, Alberti‐Violetti S, Barry R, Caproni M, Carey B, Carrozzo M, Caux F, Cianchini G, Corrà A, Diercks G, Dikkers F, Di Zenzo G, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Marzano A, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Prost C, Rauz S, van Rhijn B, Roth M, Schmidt E, Setterfield J, Zambruno G, Zillikens D, Horváth B. European guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part I. J Eur Acad Dermatol Venereol 2021; 35:1750-1764. [PMID: 34245180 PMCID: PMC8457055 DOI: 10.1111/jdv.17397] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022]
Abstract
This guideline on mucous membrane pemphigoid (MMP) has been elaborated by the Task Force for Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology (EADV) with a contribution of physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline encompassing a systematic review of the literature until June 2019 in the MEDLINE and EMBASE databases. This first part covers methodology, the clinical definition of MMP, epidemiology, MMP subtypes, immunopathological characteristics, disease assessment and outcome scores. MMP describes a group of autoimmune skin and mucous membrane blistering diseases, characterized by a chronic course and by predominant involvement of the mucous membranes, such as the oral, ocular, nasal, nasopharyngeal, anogenital, laryngeal and oesophageal mucosa. MMP patients may present with mono- or multisite involvement. Patients' autoantibodies have been shown to be predominantly directed against BP180 (also called BPAG2, type XVII collagen), BP230, laminin 332 and type VII collagen, components of junctional adhesion complexes promoting epithelial stromal attachment in stratified epithelia. Various disease assessment scores are available, including the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), the Autoimmune Bullous Skin disorder Intensity Score (ABSIS), the 'Cicatrising Conjunctivitis Assessment Tool' and the Oral Disease Severity Score (ODSS). Patient-reported outcome measurements (PROMs), including DLQI, ABQOL and TABQOL, can be used for assessment of quality of life to evaluate the effectiveness of therapeutic interventions and monitor disease course.
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Nagieb CS, Harhash TAE, Fayed HL, Ali S. Evaluation of diode laser versus topical corticosteroid in management of Behcet's disease-associated oral ulcers: a randomized clinical trial. Clin Oral Investig 2021; 26:697-704. [PMID: 34212234 DOI: 10.1007/s00784-021-04047-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The current trial was conducted to assess the effect of diode laser therapy compared to topical corticosteroid in management of oral ulcers of BD. MATERIALS AND METHODS Fifty patients were divided randomly into two parallel groups. The first group received 980 nm diode laser; the second group received topical corticosteroid (0.1% triamcinolone acetonide). The outcome measures included oral ulcer activity index (composite index), pain (VAS), number of oral ulcers, healing time, and oral health-related quality of life (OHIP-14). The collected data were analyzed for any statistical significance. RESULTS A statistically significant difference was detected between laser and corticosteroid groups favoring laser on comparing composite index and VAS scores on the first and third days and on comparing number of ulcers on the third and fifth days. A statistically significant difference was detected between laser and corticosteroid groups on comparing scores of the questions assessing discomfort with eating food, irritability with other people, taste worsening, unsatisfactory diet, and painful aching on the first and/or third days. No adverse effects were reported by participants of both groups. CONCLUSIONS Diode laser is efficient safe treatment modality for management of BD-associated oral ulcers. Diode laser was more efficient than triamcinolone acetonide in controlling pain and reducing oral ulcer activity. CLINICAL RELEVANCE Laser therapy is efficient safe modality that could spare BD patient from adding a new medication to their long list, being just one visit compared to other regular daily regimen medications. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT03771768.
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Affiliation(s)
- Clair Sobhy Nagieb
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, 11553, Egypt
| | - Tarek Abd-ElHamid Harhash
- Department of Laser Application in Dentistry, National Institute for Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Hala Lotfy Fayed
- Department of Rheumatology & Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shereen Ali
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, 11553, Egypt.
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Association between Clinical Signs of Oral Lichen Planus and Oral Health-Related Quality of Life: A Preliminary Study. Dent J (Basel) 2020; 8:dj8040113. [PMID: 33020378 PMCID: PMC7711772 DOI: 10.3390/dj8040113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/06/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023] Open
Abstract
Subjective patient’s symptoms and Oral Health-Related Quality of Life (OHRQoL) are recommended to be involved in oral lichen planus (OLP) studies. This study aims to assess the OHRQoL of OLP patients, and their associations with pain and OLP in Thai patients. Sixty-nine patients were interviewed using the Numeric Rating Scale (NRS) for pain perception and Oral Impacts on Daily Performance (OIDP) index. OLP signs examined included localization, types, number of affected sides and clinical severity using the Thongprasom sign scoring system. There were significant associations (rs = 0.490, p < 0.001) between clinical severity and the intensity of oral impacts as well as pain (rs = 0.298, p = 0.013). The intensity of oral impacts and pain increased according to the increasing OLP clinical severity, except for the white striae lesions (Thongprasom sign score 1). The erosive/ulcerative OLP lesions (Thongprasom sign scores 4 and 5) were the most painful symptom and had the highest degree of oral impacts (p < 0.001). No significant associations were found between the number of affected lesion sides and OHRQoL (p = 0.316) and pain (p = 0.284). OHRQoL was associated with OLP type and clinical severity but not with the number of affected sides.
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Lorenzo-Pouso AI, Rodríguez-González F, Blanco-Carrión A, García-García A, Chamorro-Petronacci C, López-Jornet P, Pérez-Sayáns M. Validity, reliability and optimisation of the TOPICOP questionnaire for oral lichen planus. Acta Odontol Scand 2020; 78:501-508. [PMID: 32189543 DOI: 10.1080/00016357.2020.1739329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Due to their anti-inflammatory and immunosuppressive effects, topical corticosteroids (TCs) are commonly used for the treatment of patients with oral lichen planus (OLP) with an erosive or ulcerative component. It has been suggested that many of these patients may suffer from fear or anxiety as a result of prolonged treatment with TCs. The objective of this study was twofold: (1) to optimise a patient reported outcome measure (PROM) in order to explore this feature, and (2) to evaluate this PROM in the treatment of OLP patients.Methods: A group of qualitative researchers adapted the TOPICOP questionnaire in order for it to be used as a PROM for OLP via structural equation modelling (SEM) and internal consistency (IC) analysis. Consequently, 34 patients with symptomatic OLP who were undergoing treatment with TCs completed a questionnaire and underwent a clinical assessment.Results: SEM presented an adequate fit (RMSA = 0.07, CFI = 0.94 and WRMR = 1.18), as well as a high IC (α = 0.81). A total of 16 patients (47.1%) reported TCs phobia. The receiver operating characteristic analysis (ROC) revealed that a TOPICOP value ≥50% predicted the presence of TCs phobia with a sensitivity of 93% and a specificity of 100%.Conclusions: The optimised TOPICOP scale proved valuable as a PROM in OLP. TCs phobia can be a real consideration in OLP, nonetheless, it does not appear to be an impediment to treatment adherence.
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Affiliation(s)
- Alejandro I. Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Fernando Rodríguez-González
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Cintia Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Pía López-Jornet
- Department of Oral Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Espinardo, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
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12
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Lodi G, Manfredi M, Mercadante V, Murphy R, Carrozzo M. Interventions for treating oral lichen planus: corticosteroid therapies. Cochrane Database Syst Rev 2020; 2:CD001168. [PMID: 32108333 PMCID: PMC7047223 DOI: 10.1002/14651858.cd001168.pub3] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a relatively common chronic T cell-mediated disease, which can cause significant pain, particularly in its erosive or ulcerative forms. As pain is the indication for treatment of OLP, pain resolution is the primary outcome for this review. This review is an update of a version last published in 2011, but focuses on the evidence for corticosteroid treatment only. A second review considering non-corticosteroid treatments is in progress. OBJECTIVES To assess the effects and safety of corticosteroids, in any formulation, for treating people with symptoms of oral lichen planus. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 25 February 2019: Cochrane Oral Health's Trials Register, CENTRAL (2019, Issue 1), MEDLINE Ovid, and Embase Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. There were no restrictions on language or date of publication. SELECTION CRITERIA We considered randomised controlled clinical trials (RCTs) of any local or systemic corticosteroid treatment compared with a placebo, a calcineurin inhibitor, another corticosteroid, any other local or systemic (or both) drug, or the same corticosteroid plus an adjunctive treatment. DATA COLLECTION AND ANALYSIS Three review authors independently scanned the titles and abstracts of all reports identified, and assessed risk of bias using the Cochrane tool and extracted data from included studies. For dichotomous outcomes, we expressed the estimates of effects of an intervention as risk ratios (RR), with 95% confidence intervals (CI). For continuous outcomes, we used mean differences (MD) and 95% CI. The statistical unit of analysis was the participant. We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. MAIN RESULTS We included 35 studies (1474 participants) in this review. We assessed seven studies at low risk of bias overall, 11 at unclear and the remaining 17 studies at high risk of bias. We present results for our main outcomes, pain and clinical resolution measured at the end of the treatment course (between one week and six months), and adverse effects. The limited evidence available for comparisons between different corticosteroids, and corticosteroids versus alternative or adjunctive treatments is presented in the full review. Corticosteroids versus placebo Three studies evaluated the effectiveness and safety of topical corticosteroids in an adhesive base compared to placebo. We were able to combine two studies in meta-analyses, one evaluating clobetasol propionate and the other flucinonide. We found low-certainty evidence that pain may be more likely to be resolved when using a topical corticosteroid rather than a placebo (RR 1.91, 95% CI 1.08 to 3.36; 2 studies, 72 participants; I² = 0%). The results for clinical effect of treatment and adverse effects were inconclusive (clinical resolution: RR 6.00, 95% CI 0.76 to 47.58; 2 studies, 72 participants; I² = 0%; very low-certainty evidence; adverse effects RR 1.48, 95% 0.48 to 4.56; 3 studies, 88 participants, I² = 0%, very low-certainty evidence). Corticosteroids versus calcineurin inhibitors Three studies compared topical clobetasol propionate versus topical tacrolimus. We found very low-certainty evidence regarding any difference between tacrolimus and clobetasol for the outcomes pain resolution (RR 0.45, 95% CI 0.24 to 0.88; 2 studies, 100 participants; I² = 80%), clinical resolution (RR 0.61, 95% CI 0.38 to 0.99; 2 studies, 52 participants; I² = 95%) and adverse effects (RR 0.05, 95% CI 0.00 to 0.83; 2 studies, 100 participants; very low-certainty evidence) . One study (39 participants) compared topical clobetasol and ciclosporin, and provided only very low-certainty evidence regarding the rate of clinical resolution with clobetasol (RR 3.16, 95% CI 1.00 to 9.93), pain resolution (RR 2.11, 95% CI 0.76 to 5.86) and adverse effects (RR 6.32, 95% CI 0.84 to 47.69). Two studies (60 participants) that compared triamcinolone and tacrolimus found uncertain evidence regarding the rate of clinical resolution (RR 0.86, 95% CI 0.55 to 1.35; very low-certainty evidence) and that there may be a lower rate of adverse effects in the triamcinolone group (RR 0.47, 95% CI 0.22 to 0.99; low-certainty evidence). These studies did not report on pain resolution. AUTHORS' CONCLUSIONS Corticosteroids have been first line for the treatment of OLP. This review found that these drugs, delivered topically as adhesive gels or similar preparations, may be more effective than placebo for reducing the pain of symptomatic OLP; however, with the small number of studies and participants, our confidence in the reliability of this finding is low. The results for clinical response were inconclusive, and we are uncertain about adverse effects. Very low-certainty evidence suggests that calcineurin inhibitors, specifically tacrolimus, may be more effective at resolving pain than corticosteroids, although there is some uncertainty about adverse effects and clinical response to tacrolimus showed conflicting results.
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Affiliation(s)
- Giovanni Lodi
- University of MilanDepartment of Biomedical, Surgical and Dental SciencesVia Beldiletto 1/3MilanItaly20142
| | - Maddalena Manfredi
- University of ParmaPolo Clinico di Odontostomatologia, SBiBiT DepartmentVia Gramsci, 14ParmaItaly43100
| | - Valeria Mercadante
- University College of LondonEastman Dental Institute256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Ruth Murphy
- Sheffield Children's NHS Foundation TrustDepartment of Dermatology, Sheffield Children's HospitalSheffieldUKS10 2JF
| | - Marco Carrozzo
- University of Newcastle upon TyneDepartment of Oral Medicine, School of Dental SciencesFramlington PlaceNewcastle upon TyneUKNE2 4BW
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13
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Design of Oral Mucositis Disease Questionnaire. PAJOUHAN SCIENTIFIC JOURNAL 2020. [DOI: 10.52547/psj.18.2.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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14
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da Mata ADSP, Amaral JPDAR, Thomson WM, Barcelos F, Vaz Patto J, Pereira RMN, Marques DNDS. Patient-related outcomes in Sjögren syndrome treated with stimulants of salivary secretion: Randomized clinical trial. Oral Dis 2019; 26:313-324. [PMID: 31814226 DOI: 10.1111/odi.13251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the impact of gustatory stimulants of salivary secretion (GSSS) on Sjögren's syndrome patients' self-perception of xerostomia, oral health-related quality of life (OHRQoL) and salivary secretion. METHODS A total of 110 Sjögren's syndrome patients were randomly allocated to be treated with either a malic acid lozenge or a citric acid mouthwash and then crossed over. Before and after the interventions, the Xerostomia Inventory 5 (SXI-5-PL) and the Oral Health Impact Profile (OHIP-14-PT) questionnaires (both in the Portuguese language) were administered to patients. Unstimulated, mechanical and gustatory-stimulated salivary flows were determined. Repeated measures and between-subject analyses were performed. Statistical significance was set at 5%. RESULTS After the intervention and within each group, both GSSS elicited a reduction in the SXI-5-PL and OHIP-14-PT scores and an increase in salivary output, significant in the malic acid lozenge group. The malic acid treatment resulted in a greater effect size and percentage improvement than citric acid mouthwash. The malic acid lozenge also produced a significant greater salivary output than the citric acid rising solution. CONCLUSIONS In Sjögren's syndrome patients, lozenges containing malic acid increased saliva production and xerostomia relief, resulting in improved quality of life.
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Affiliation(s)
- António Duarte Sola Pereira da Mata
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,New York University, New York, NY, USA.,Clinic Hugo Madeira-Advanced Aesthetics & Implantology, Lisboa, Portugal
| | - João Pedro de Almeida Rato Amaral
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - William Murray Thomson
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | | | | | - Ruben Miguel Nunes Pereira
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Nuno da Silva Marques
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Implantology Institute, Lisboa, Portugal
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15
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Ormond M, McParland H, Thakrar P, Donaldson ANA, Andiappan M, Cook RJ, Escudier ME, Higham J, Hullah E, McMillan R, Taylor J, Shirlaw PJ, Challacombe SJ, Setterfield JF. Validation of an Oral Disease Severity Score (ODSS) tool for use in oral mucous membrane pemphigoid. Br J Dermatol 2019; 183:78-85. [PMID: 31571192 DOI: 10.1111/bjd.18566] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mucous membrane pemphigoid (MMP) is a rare autoimmune bullous disease predominantly affecting the oral mucosa. Optimal management relies upon thorough clinical assessment and documentation at each visit. OBJECTIVES The primary aim of this study was to validate the Oral Disease Severity Score (ODSS) for the assessment of oral involvement in MMP. We also compared its inter- and intraobserver reliability with those of the oral parts of the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Physician's Global Assessment (PGA). METHODS Fifteen patients with mild-to-moderately severe oral MMP were scored for disease severity by 10 oral medicine clinicians from four U.K. centres using the ODSS, the oral sections of MMPDAI and ABSIS, and PGA. Two clinicians rescored all patients after 2 h. RESULTS In terms of reliability, the interobserver ODSS total score intraclass correlation coefficient (ICC) was 0·97, MMPDAI activity 0·59 and damage 0·15, ABSIS total 0·84, and PGA 0·72. The intraobserver ICCs (two observers) for ODSS total were 0·97 and 0·93; for MMPDAI activity 0·93 and 0·70 and damage 0·93 and 0·79; for ABSIS total 0·99 and 0·94; and for PGA 0·92 and 0·94. Convergent validity between ODSS and MMPDAI was good (correlation coefficient 0·88). The mean ± SD time for completion of ODSS was 93 ± 31 s, with MMPDAI 102 ± 24 s and ABSIS involvement 71 ± 18 s. The PGA took < 5 s. CONCLUSIONS This study has validated the ODSS for the assessment of oral MMP. It has shown superior interobserver agreement over MMPDAI, ABSIS and PGA, and superior intraobserver reliability to MMPDAI. It is quick and easy to perform. What's already known about this topic? There are no validated scoring methodologies for oral mucous membrane pemphigoid (MMP). Proposed disease activity scoring tools for MMP include the Mucous Membrane Disease Area Index (MMPDAI) and the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). The Oral Disease Severity Score (ODSS) has been validated for use in oral pemphigus vulgaris (PV). It has been shown to be reliable and sensitive in both lichen planus (LP) and MMP. What does this study add? The ODSS has been shown to be a thorough, sensitive and reproducible, yet quick scoring tool for the assessment of oral involvement in MMP. Its versatility for use in oral PV, MMP and LP is an added advantage over other scoring methodologies. What are the clinical implications of this work? We propose that the ODSS be used as a clinical scoring tool for monitoring activity in oral MMP in clinical practice as well as for use in multicentre studies.
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Affiliation(s)
- M Ormond
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - H McParland
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - P Thakrar
- Department of Oral Medicine, Birmingham Dental Hospital and School of Dentistry, Birmingham, U.K
| | - A N A Donaldson
- Biostatistics and Research Methods Centre, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K
| | - M Andiappan
- Biostatistics and Research Methods Centre, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K
| | - R J Cook
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K.,Centre for Oral Clinical and Translational Sciences, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K
| | - M E Escudier
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K.,Centre for Host-Microbiome Interactions, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K
| | - J Higham
- Department of Oral Medicine, Birmingham Dental Hospital and School of Dentistry, Birmingham, U.K
| | - E Hullah
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - R McMillan
- Department of Oral Medicine, Eastman Dental Hospital, UCLH/Eastman Dental Institute, UCL, London, U.K
| | - J Taylor
- Department of Oral Medicine, Glasgow Dental Hospital and School, Glasgow, U.K
| | - P J Shirlaw
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - S J Challacombe
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K.,Centre for Host-Microbiome Interactions, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K
| | - J F Setterfield
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K.,Centre for Host-Microbiome Interactions, King's College London Faculty of Dentistry, Oral& Craniofacial Sciences, London, U.K.,St John's Institute of Dermatology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, U.K
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16
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Burke LB, Brennan MT, Ni Riordain R, Madsen LS. Novel Oral Lichen Planus Symptom Severity Measure for assessing patients' daily symptom experience. Oral Dis 2019; 25:1564-1572. [PMID: 31006147 DOI: 10.1111/odi.13109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/27/2019] [Accepted: 04/15/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE A novel Oral Lichen Planus Symptom Severity Measure was developed as a clinical outcome assessment of the daily symptom experience of patients with oral lichen planus. METHODS A literature review and expert input were followed by open-ended concept elicitation interviews with 17 adults with oral lichen planus in the United States and Ireland. Item content was generated, and the interviews continued until input saturation was reached. The final electronic version of the measure was cognitively debriefed in 6 US patients and subsequently translated and linguistically validated in Germany and Denmark. RESULTS Concept elicitation interviews demonstrated content validity and saturation in identifying symptoms and daily activities that generate symptoms in patients with oral lichen planus. The content and electronic daily diary format demonstrated content validity during cognitive debriefing interviews. Linguistic validation of the 7-item Oral Lichen Planus Symptom Severity Measure in Germany and Denmark confirmed the content validity of the German and Danish versions. CONCLUSIONS Qualitative research methods generated evidence that the 7-item Oral Lichen Planus Symptom Severity Measure version 1.0 is a well-defined assessment tool to characterize the severity, specificity and variations of symptoms in patients with oral lichen planus.
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Affiliation(s)
| | - Michael T Brennan
- Department of Oral Medicine, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina
| | - Richeal Ni Riordain
- Department of Oral Medicine, Cork University Dental School and Hospital, Cork, Ireland
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17
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Ormond M, McParland H, Donaldson A, Andiappan M, Cook R, Escudier M, Hullah E, Higham J, McMillan R, Taylor J, Shirlaw P, Challacombe S, Setterfield J. An Oral Disease Severity Score validated for use in oral pemphigus vulgaris. Br J Dermatol 2018; 179:872-881. [DOI: 10.1111/bjd.16265] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ormond
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - H. McParland
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - A.N.A. Donaldson
- Biostatistics and Research Methods Centre; Dental Institute; King's College London; London U.K
| | - M. Andiappan
- Biostatistics and Research Methods Centre; Dental Institute; King's College London; London U.K
| | - R.J. Cook
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - M. Escudier
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
| | - E. Hullah
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - J. Higham
- Birmingham Dental Hospital; Birmingham U.K
| | - R. McMillan
- Eastman Dental Hospital; UCLH/Eastman Dental Institute; University College London; London U.K
| | - J. Taylor
- University Dental Hospital; Manchester U.K
| | - P.J. Shirlaw
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - S.J. Challacombe
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
| | - J.F. Setterfield
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
- St John's Institute of Dermatology; Guy's and St Thomas's NHS Foundation Trust; London U.K
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18
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Abstract
Oral medicine is concerned with the oral health care of patients with chronic, recurrent and medically related disorders of the oral and maxillofacial region, and with their diagnosis and non-surgical management. For historical reasons care for conditions falling within the scope of oral medicine practice has been inconsistent with limited planning of clinical services. Managed Clinical Networks (MCNs) bring advantages to all stakeholders with a positive impact on patient pathways and access to equitable and quality care across a network of providers working in a coordinated way to make best use of NHS resources. MCNs provide a framework to address the limitations of legacy arrangements and are very relevant to dentistry. Here we describe oral medicine MCN development in Yorkshire and the Humber within the framework of the Five year forward view NHS policy. A step-wise approach is being taken across the region to introduce an MCN model that reflects cooperative working between oral medicine, oral surgery, oral & maxillofacial surgery and other stakeholders. Preliminary data are already informing how a regional oral medicine MCN can be further developed with the potential for translation of the lessons learned to other regions.
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19
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Ní Ríordáin R, Wiriyakijja P. Patient reported outcome and experience measures of oral disease in oral medicine. Br Dent J 2017; 223:713. [DOI: 10.1038/sj.bdj.2017.889] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2017] [Indexed: 11/09/2022]
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20
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The use of topical steroid preparations in oral medicine in the UK. Br Dent J 2017; 223:633-638. [DOI: 10.1038/sj.bdj.2017.880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 11/08/2022]
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21
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Tadakamadla J, Kumar S, Lalloo R, Gandhi Babu DB, Johnson NW. Impact of oral potentially malignant disorders on quality of life. J Oral Pathol Med 2017; 47:60-65. [PMID: 28766765 DOI: 10.1111/jop.12620] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients. METHODS Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF-12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF-12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS). RESULTS A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, "physical impairment and functional limitations" than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased. CONCLUSIONS OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.
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Affiliation(s)
- Jyothi Tadakamadla
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Santhosh Kumar
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, St Lucia, Qld, Australia
| | - Dara Balaji Gandhi Babu
- Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, Telangana, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
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22
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Wiriyakijja P, Fedele S, Porter S, Mercadante V, Ni Riordain R. Patient-reported outcome measures in recurrent aphthous stomatitis: A critical assessment of quality properties. Oral Dis 2017; 23:1168-1179. [PMID: 28779517 DOI: 10.1111/odi.12726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/17/2017] [Accepted: 07/30/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To analyse the range of existing patient-reported outcome measures (PROMs) used in studies of recurrent aphthous stomatitis (RAS) and to evaluate their quality properties via the assessment of psychometric properties and interpretability. MATERIALS AND METHODS Electronic databases were searched to identify relevant publications related to PROMs used in RAS. Publications were selected based on predefined criteria. All identified PROMs were then classified by measuring concepts and assessed for instrument characteristics and evidence for quality properties for RAS patients. RESULTS Twenty-eight PROMs were used in studies of RAS patients. Instruments focused upon oral symptoms (n = 4), psychosocial status (n = 15) and quality of life (n = 9). Five PROMs (Oral Health-related Quality of Life-UK, Chronic Oral Mucosal Disease Questionnaire, Oral Health Impact Profile-14, Medical Outcome Study Short Form-36 and Mumcu's composite index) were found to have some evidence of psychometric performance. No PROMs showed evidence for interpretability of their scores in RAS patients. CONCLUSION There was a wide range of PROMs used in clinical studies of RAS. The majority of these PROMs lack evidence of measurement properties and interpretability for RAS patients. Further studies are required to confirm whether these instruments are suitable and useful for this patient group.
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Affiliation(s)
- P Wiriyakijja
- UCL Eastman Dental Institute, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Fedele
- UCL Eastman Dental Institute, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - S Porter
- UCL Eastman Dental Institute, London, UK
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23
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Wiriyakijja P, Fedele S, Porter SR, Mercadante V, Ni Riordain R. Patient-reported outcome measures in oral lichen planus: A comprehensive review of the literature with focus on psychometric properties and interpretability. J Oral Pathol Med 2017. [DOI: 10.1111/jop.12604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Paswach Wiriyakijja
- UCL Eastman Dental Institute; London UK
- Department of Oral Medicine; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Stefano Fedele
- UCL Eastman Dental Institute; London UK
- NIHR University College London Hospitals Biomedical Research Centre; London UK
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Chung YL, Pui NNM. Confounding factors associated with oral mucositis assessment in patients receiving chemoradiotherapy for head and neck cancer. Support Care Cancer 2017; 25:2743-2751. [PMID: 28353040 DOI: 10.1007/s00520-017-3684-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/20/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study was to identify patient-centered, mucositis-associated adverse impact factors and events that might confound physician-assessed oral mucositis (OM) in head and neck cancer (HNC) patients receiving chemoradiotherapy. METHODS This was a post hoc analysis of a previously conducted randomized trial to determine the efficacy of 5% phenylbutyrate mouthwash in preventing chemoradiotherapy-induced OM. This analysis identified patient-centered symptomatic, observable, and measurable factors that may confound physician scoring of the severity of OM during chemoradiotherapy. Confounding factors were then combined with physician-rated OM scores according to World Health Organization (WHO) and OM Assessment Scale (OMAS) criteria to investigate the therapeutic implications of OM treatment. RESULTS The original analysis found no significant differences between experimental and placebo groups with respect to the cumulative incidence of physician-recorded severe OM (WHO ≥3 or OMAS ≥2), patient-reported adverse events, and opioid use. However, patients in the experimental arm had relatively lower rates of OM-associated adverse clinical issues including unplanned short radiation breaks, skipping of chemotherapy, nausea/vomiting, late loss of body weight, and early opioid use, all of which could potentially interfere with physician-assessed OM scoring. When WHO OM grade (functional impact and pain), OMAS ulceration size (organic impact), and prolonged radiation treatment time (cancer treatment impact) were combined, there were significantly fewer interruptions of chemoradiotherapy treatment in symptomatic OM patients in the experimental compared to the placebo group. The benefits conferred by reducing the amount of chemoradiotherapy-related, OM-associated adverse impacts in the experimental group were reflected by better 5-year locoregional recurrence-free survival. CONCLUSIONS This exploratory study raises questions as to whether the severity reflected by physician-rated OM scores is in concordance with OM-induced adverse impacts on HNC patients. Further investigations are warranted to identify patient-related and cancer-associated symptom burdens that may affect tolerance, compliance, and outcome of chemoradiotherapy and confound the evaluation of therapeutic effects on chemoradiotherapy-induced OM.
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Affiliation(s)
- Yih-Lin Chung
- Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, No. 125 Lih-Der Road, Pei-Tou District, Taipei, 112, Taiwan.
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Rosen EB, Donoff RB, Riedy CA. U.S. Dental School Deans’ Views on the Value of Patient-Reported Outcome Measures in Dentistry. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.6.tb06134.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ni Riordain R, Hodgson T, Porter S, Fedele S. Validity and reliability of the Chronic Oral Mucosal Diseases Questionnaire in a UK population. J Oral Pathol Med 2016; 45:613-6. [DOI: 10.1111/jop.12425] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Tim Hodgson
- Oral Medicine Unit; UCLH NHS Foundation Trust; Eastman Dental Hospital; UCL Eastman Dental Institute; London UK
| | - Stephen Porter
- UCL Eastman Dental Institute London; University College London; London UK
- Biomedical Research Centre; NIHR University College London Hospitals; London UK
| | - Stefano Fedele
- UCL Eastman Dental Institute London; University College London; London UK
- Biomedical Research Centre; NIHR University College London Hospitals; London UK
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